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Suicide and suicidal thoughts

Suicide, taking your own life, is a tragic reaction to stressful life situations — and all the more tragic because suicide can be prevented. Whether you're considering suicide or know someone who feels suicidal, learn suicide warning signs and how to reach out for immediate help and professional treatment. You may save a life — your own or someone else's.

It may seem like there's no way to solve your problems and that suicide is the only way to end the pain. But you can take steps to stay safe — and start enjoying your life again.

Symptoms
Causes
Risk factors
Complications
Prevention

Suicide warning signs or suicidal thoughts include:

Talking about suicide — for example, making statements such as "I'm going to kill myself," "I wish I was dead" or "I wish I hadn't been born"

Getting the means to commit suicide, such as buying a gun or stockpiling pills

Withdrawing from social contact and wanting to be left alone

Having mood swings, such as being emotionally high one day and deeply discouraged the next

Being preoccupied with death, dying or violence

Feeling trapped or hopeless about a situation

Increasing use of alcohol or drugs

Changing normal routine, including eating or sleeping patterns

Doing risky or self-destructive things, such as using drugs or driving recklessly

Giving away belongings or getting affairs in order when there is no other logical explanation for why this is being done

Saying goodbye to people as if they won't be seen again

Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above

Warning signs aren't always obvious, and they may vary from person to person. Some people make their intentions clear, while others keep suicidal thoughts and feelings secret.

When to see a doctor

If you think you may hurt yourself or attempt suicide, get help right now:

Call 911 or your local emergency number immediately.

Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.

If you're feeling suicidal, but you aren't immediately thinking of hurting yourself:

Reach out to a close friend or loved one — even though it may be hard to talk about your feelings

Contact a minister, spiritual leader or someone in your faith community

Call a suicide crisis center hotline

Make an appointment with your doctor, other health care provider or mental health provider

Suicidal thinking doesn't get better on its own — so get help.

Related

When you call your primary care doctor to set up an appointment, you may be referred immediately to a psychiatrist. If you're in danger of committing suicide, your doctor may have you get emergency help at the hospital.

What you can do

Take these steps before your appointment:

Write down key personal information, including any major stresses or recent life changes.

Make a list of all medications, vitamins and supplements that you're taking.

Take a family member or friend along if possible — someone who accompanies you may remember something that you missed or forgot.

Write down questions to ask your doctor.

Some basic questions to ask your doctor include:

Are my suicidal thoughts most likely linked to an underlying mental or physical health problem?

Other than the most likely cause, what are other possible causes?

Will I need any tests for possible underlying conditions?

Do I need immediate treatment of some kind? What will that involve?

What are the alternatives to the approach that you're suggesting?

I have these other mental or physical health problems. How can I best manage them together?

Is there anything special I should do to stay safe and feel better?

Should I see a psychiatrist? Will my insurance cover it?

Is there a generic alternative to the medicine you're prescribing me?

Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

Don't hesitate to ask questions during your appointment when you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. To save time, be ready to answer them.

When did you first begin having suicidal thoughts?

Have your suicidal thoughts been continuous or occasional?

Have you ever tried to commit suicide?

Do you have a plan to kill yourself now?

If you have a plan, does it involve a specific method, place or time?

Have you made any preparations, such as gathering pills, changing your will or writing suicide notes?

Do you feel like you can control your impulses when you feel reckless or like killing or hurting yourself?

Do you have friends or family members you can talk to or go to for help?

What are your feelings about the future? Do you have any hope that things will improve?

Do you drink alcohol, and if so, how much and how often?

What medications do you take?

Do you use illegal drugs?

What, if anything, seems to improve your suicidal thoughts?

What, if anything, appears to worsen your suicidal thoughts?

What you can do in the meantime

If you've scheduled an appointment and can't see your doctor immediately, make sure you stay safe. Contact family members, friends or other people you trust to help you. If you feel you're in danger of hurting yourself or attempting suicide, call 911 or get emergency help immediately.

Your doctor may do a physical exam, tests and in-depth questioning about your mental and physical health to help determine what may be causing your suicidal thinking and to determine the best treatment.

Mental health conditions

In most cases, suicidal thoughts are linked to an underlying mental health issue that can be treated. If this is the case, you may need to see a doctor who specializes in diagnosing and treating mental illness (psychiatrist) or other mental health provider.

Physical causes

In some cases, suicidal thinking may be linked to an underlying physical health problem. You may need blood tests and other tests to determine whether this is the case.

Alcohol and drugs

For many people, alcohol or drugs play a role in suicidal thinking and completed suicide. Your doctor will want to know whether you have any problems with alcohol or drug use — such as bingeing or being unable to cut back or quit using alcohol on your own. Many people who feel suicidal need treatment to help them stop using alcohol or drugs for their suicidal feelings to improve.

In some people, certain prescription or over-the-counter drugs can cause suicidal feelings. Tell your doctor about any medications you take to see whether they could be linked to your suicidal thinking.

Children and teenagers

Children who are feeling suicidal usually need to see a psychiatrist or psychologist experienced in diagnosing and treating children with mental health problems. The doctor will want to get an accurate picture of what's going on from a variety of sources, such as the young person, parents or guardians, other people close to the child, school reports, and previous medical or psychiatric evaluations.

Treatment of suicidal thoughts and behavior depends on your specific situation, including your level of suicide risk and what underlying problems may be causing your suicidal thoughts or behavior.

Emergencies

If you've made a suicide attempt and you're injured:

Call 911 or your local emergency number

Have someone else call if you're not alone

If you're not injured, but you're at immediate risk of harming yourself:

Call 911 or your local emergency number

Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.

At the emergency room, you'll be treated for any injuries. The doctor will ask you a number of questions and may examine you, looking for recent or past signs of suicide attempts. Depending on your state of mind, you may need medications to calm you or to ease symptoms of an underlying mental illness, such as depression.

Your doctor may want you to stay in the hospital long enough to make sure any treatments are working, that you'll be safe when you leave and that you'll get the follow-up treatment you need.

Nonemergency situations

If you have suicidal thoughts, but aren't in a crisis situation, you may need outpatient treatment. This treatment may include:

Psychotherapy. In psychotherapy, also called counseling or talk therapy, you explore the issues that make you feel suicidal. You and your therapist can work together to develop treatment plans and goals.

Medications. Antidepressants, antipsychotic medications, anti-anxiety medications and other medications for mental illness can help reduce symptoms, which can help you feel less suicidal.

Addiction treatment. Treatment for drug or alcohol addiction can include detoxification, addiction treatment programs and self-help group meetings.

Family support and education. Your loved ones can be both a source of support and conflict. Involving them in treatment can help them understand what you're going through, give them better coping skills, and improve family communication and relationships.

Helping a loved one with suicidal thoughts

If you have a loved one who has attempted suicide, or if you think your loved one may be in danger of doing so, get emergency help.

If you have a loved one you think may be considering suicide, have an open and honest discussion about your concerns. You may not be able to force someone to seek professional care, but you can offer encouragement and support. You can also help your loved one find a qualified doctor or mental health provider and make an appointment. You may even be able to go to an appointment with him or her.

Supporting a loved one who is chronically suicidal can be stressful and exhausting. You may be afraid and feel guilty and helpless. Take advantage of resources about suicide and suicide prevention so that you have information and tools to take action when needed. Also, be sure to take care of yourself by getting support from family, friends, organizations and professionals.

Don't try to manage suicidal thoughts or behavior entirely on your own. You need professional help and support to overcome the problems linked to suicidal thinking. In addition:

Go to your appointments. Don't skip therapy sessions or doctor's appointments, even if you don't want to go or don't feel like you need to.

Take medications as directed. Even if you're feeling well, don't skip your medications. If you stop, your suicidal feelings may come back. You could also experience withdrawal-like symptoms from abruptly stopping an antidepressant or other medication.

Learn about your condition. Learning about your condition can empower and motivate you to stick to your treatment plan. If you have depression, for instance, learn about its causes and treatments.

Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your suicidal feelings. Make a plan so you know what to do if suicidal thoughts return. Contact your doctor or therapist if you notice any changes in how you feel. Consider involving family members or friends in watching for warning signs.

Seek help from a support group. A number of organizations are available to help you cope with suicidal thinking and recognize that there are many options in your life other than suicide.